Table system for medical imaging

ABSTRACT

A table system for use with an imaging device includes a base portion that supports the table system over a support surface, a patient support including a platform for supporting a patient in a standing position and a bed for supporting the patient in a lying position, a linkage portion coupled between the base portion and the patient support that is pivotable with respect to both the base portion and the patient support, a first drive mechanism that drives the pivoting of the patient support with respect to the linkage portion, and a second drive mechanism that drives the pivoting of the linkage portion with respect to the base portion, the first and second drive mechanisms moving the patient support between a vertical position in which the platform is substantially parallel to the support surface and a horizontal position in which the bed is substantially parallel to the support surface.

RELATED APPLICATION

This application claims the benefit of priority to U.S. ProvisionalApplication No. 62/380,595, filed on Aug. 29, 2016, the entire contentsof which are incorporated herein by reference.

BACKGROUND

A variety of patient supports (e.g., tables) are used for differentmedical imaging applications, such as x-ray fluoroscopic and computedtomography (CT) imaging and magnetic resonance (MR) imaging. Thesepatient supports are often designed for use with a particular device ortype of imaging device. For example, a patient support for an x-ray CTimaging device may be designed and dimensioned for sliding a patient inand out of an imaging bore of the device.

In many cases, it can be difficult to load and unload patients from thesupports commonly used with medical imaging equipment. In addition,conventional patient supports may be limited in the types imagingdevices they can be used with and/or the positions in which they cansupport a patient. Conventional patient supports may also need to bemade relatively large and/or heavy to minimize dynamic sagging as thesupport slides in and out of the bore of an imaging device.

There is a continuing need for an improved patient support for medicalimaging.

SUMMARY

Embodiments include table systems for use with an imaging device thatinclude a base portion that supports the table system over a supportsurface, a patient support including a platform sized and shaped tosupport a patient in a standing position and a bed sized and shaped tosupport the patient in a lying position, a linkage portion coupledbetween the base portion and the patient support that is pivotable withrespect to both the base portion and the patient support, a first drivemechanism that drives the pivoting of the patient support with respectto the linkage portion, and a second drive mechanism that drives thepivoting of the linkage portion with respect to the base portion, thefirst and second drive mechanisms moving the patient support between avertical position in which the platform is substantially parallel to thesupport surface and a horizontal position in which the bed issubstantially parallel to the support surface.

BRIEF DESCRIPTION OF THE DRAWINGS

Other features and advantages of the present invention will be apparentfrom the following detailed description of the invention, taken inconjunction with the accompanying drawings of which:

FIG. 1 is a perspective view of a table system with a patient support ina vertical position according to an embodiment.

FIG. 2 is a side view of a table system illustrating the pivoting motionof the patient support according to an embodiment.

FIG. 3 is a perspective view of a table system with a linkage portionpivoted upwards and the patient support pivoted to a horizontalposition.

FIG. 4 is a perspective view of a table system with the patient supportin a lowered position.

FIG. 5 is a front perspective view of a table system with the patientsupport pivoted upwards to a vertical position.

FIG. 6 is a rear perspective view of a table system with a covering ofthe linkage portion partially removed.

DETAILED DESCRIPTION

The various embodiments will be described in detail with reference tothe accompanying drawings. Wherever possible, the same reference numberswill be used throughout the drawings to refer to the same or like parts.References made to particular examples and implementations are forillustrative purposes, and are not intended to limit the scope of theinvention or the claims.

Embodiments include a table system for use with an imaging device, suchas a diagnostic medical imaging device. As shown in FIGS. 1-6, a tablesystem 100 according to various embodiments may include a base portion101 configured to support the table system 100 over a support surface(e.g., a floor 102), a patient support 103 which includes a platform 105sized and shaped to support a patient in a standing position and a bed107 sized and shaped to support the patient in a lying position, and alinkage portion 109 coupled between the base portion 101 and the patientsupport 103 that is pivotable with respect to both the base portion 101and the patient support 103. A first drive mechanism may be located inthe linkage portion 109 and may drive the pivoting of the linkageportion 109 with respect to the patient support 103. A second drivemechanism may also be located in the linkage portion 109 and may drivethe pivoting of the linkage portion 109 with respect to the base portion101. In embodiments, the patient support 103 may be positioned in avertical position (as shown in FIGS. 1, 5 and 6) in which the platform105 is substantially parallel to the support surface (e.g., floor 102)and a horizontal position (as shown in FIGS. 3 and 4) in which the bed107 is substantially parallel to the support surface (e.g., floor 102).As used herein, the term “substantially parallel” means ±15° from anexactly parallel position. The patient support 103 may be positioned atany arbitrary angle between a horizontal and vertical configuration. Asshown in FIG. 2, for example, the patient support 103 may be tilted at a45° angle between a vertical and horizontal position. In embodiments,the patient support 103 may stably support the full weight of a humanbody and may support greater than 200 kg, such as up to about 800 kg,over the full range of pivoting motions of the patient support 103 andlinkage portion 109.

The patient support 103 may include an elongated first portion 111having a surface forming the bed 107 which may support a patient in alying or inclined position and a second portion 113 having a surfaceforming the platform 105 which may support a patient in a weight-bearingstanding or inclined position. The first portion 111 may have a lengthdimension that is preferably greater than the average height of an adulthuman, such as between 2-3 meters (e.g., about 2.5 meters). The secondportion 113 may extend substantially perpendicular to the first portion111 at a first end 115 of the first portion 111. As used herein, theterm “substantially perpendicular” means ±15° from an exactlyperpendicular position. The second portion 113 may have a lengthdimension that is less than the length dimension of the first portion111. In embodiments, the length dimension of the second portion 113 maybe between 20-50 cm (e.g., about 35 cm), and may be greater than theaverage foot length of an adult human to enable a patient to comfortablystand on the platform 105. The width of the first and second portions111, 113 may be greater than the average width of an adult human (e.g.,average shoulder width in the case of the first portion 111 and/oraverage stance width in the case of the second portion 113) and may beat least about 40 cm. The width of the first and/or second portions 111,113 may be less than a bore diameter of a medical imaging device (e.g.,an x-ray CT scanner or Mill device), such as less than about 120 cm, andmay be between about 50 and 80 cm.

The bed 107 of the first portion 111 may be concavely curved, as is mostclearly visible in FIG. 5. The distal end 117 of the first portion 111may have a curved edge, as shown for example, in FIG. 1. The platform105 of the second portion 113 may also have a similar curved edge. Therounded and/or curved surfaces of the patient support 103 may help tominimize beam attenuation by the patient support 103 during an imagingscan.

As shown in FIGS. 1-6, the patient support 103 may include a pair ofbracket members 119 that may extend away from a rear surface 121 of thesecond portion 113 of the patient support 103 (i.e., opposite theplatform 105, as shown in FIGS. 2-4). The bracket members 119 may beconnected to the linkage portion 109 along an axis α to enable thepatient support 103 to pivot with respect to the linkage portion 109, asdescribed in further detail below.

The patient support 103 may be made of one or more suitablehigh-strength materials. In preferred embodiments, the patient support103 may be made of a radiolucent (i.e., x-ray transparent) material,such as carbon fiber. In one embodiment, the patient support 103 maycomprise a single piece of carbon fiber that may form at least the bed107 and the platform 105. The carbon fiber element may form a rigidouter shell that may contain a suitable lightweight and radiolucentfiller material, such as a foam. The patient support 103 may includeadditional structural reinforcing elements (e.g., plates, rods,brackets, etc.) that may or may not be radiolucent. For example, thepatient support 103 may include one or more metal (e.g., aluminum,steel, etc.) support plates which may be secured to a carbon fiberpatient support structure using fasteners. In embodiments in which thepatient support 103 includes structural reinforcing elements made from anon-radiolucent material, such as aluminum, the non-radiolucent materialmay preferably be located so as not to interfere with an imaging scan ofa patient on the patient support 103. For example, in the embodiment ofFIGS. 1-6, an aluminum support frame may be confined to the brackets119, at or near to the rear surface 121 of the second portion 113 and/oradjacent to the first end 115 of the first portion 111. This may enablea patient standing on the platform 105 to be scanned over the entirelength of the body including through the feet without interference(i.e., image artifacts) from non-radiolucent reinforcing element(s).

The base portion 101 of the table system 100 may include a pair ofparallel bracket members 201. The bracket members 201 may be fixed tothe floor or other stable support surface using fasteners, such asbolts. The bracket members 201 of the base portion 101 may be made of asuitable high-strength structural material, such as aluminum or steel.The bracket members 201 may have an angled upper surface 203 as shown inFIGS. 2-6. The angled upper surface 203 of the bracket members 201 maybe complementary to an angled surface 123 of the bracket members 119 ofthe patient support 103, as shown in FIG. 1. The bracket members 201 ofthe base portion 101 may be connected to the linkage portion 109 alongan axis α′ to enable the linkage portion 109 to pivot with respect tothe base portion 101 as described in further detail below.

The linkage portion 109 may include a flat first major surface 301 and aflat second major surface 303 that extends parallel to the first surface301. The bracket members 201 of the base portion 101 and the bracketmembers 119 of the patient support 103 may connect to the linkageportion 109 via opposing first and second side walls 305, 307 of thelinkage portion 109.

A first rotary drive shaft 309 (see FIG. 6) may extend through one orboth side walls 305, 307 of the linkage portion 109 and connect to atleast one bracket member 119 of the patient support 103. At least onerotary bearing within the linkage portion 109 may enable the firstrotary drive shaft to rotate with respect to the linkage portion 109 topivot the patient support 103 with respect to the linkage portion 109about axis α.

A second rotary drive shaft 311 (see FIG. 6) may extend through one orboth side walls 305, 307 of the linkage portion 109 and connect to atleast one bracket member 201 of the base portion 101. At least onerotary bearing within the linkage portion 109 may enable the linkageportion 109 to rotate with respect to the second rotary drive shaft 311to cause the linkage portion 109 to pivot with respect to the baseportion 101 about axis α′.

The linkage portion 109 may be made from durable, high-strengthmaterial(s) to provide a high degree of structural integrity and toprevent the components within the linkage portion 109 from beingdamaged. In one embodiment, as shown in FIG. 6, the linkage portion 109may include a rigid support frame 313 made from a suitable high-strengthmetal material, such as aluminum or steel. The support frame 313 mayinclude a support plate 315 extending adjacent and parallel to the firstmajor surface 301 of the linkage portion 109. A similar support platemay extend adjacent and parallel to the second major surface 303 of thelinkage portion 109. First and second drive systems 317, 319 for drivingthe rotation of the linkage portion 109 with respect to the patientsupport 103 and base portion 101 may be located at least partiallybetween the two support plates 315. As shown in FIG. 6, one or moreblock members 321 for supporting rotary bearing(s) 323 for a rotarydrive shaft 311 may be secured between the support plates 315. A similarconfiguration may also be located on the opposite side of the linkageportion 109 to support the other rotary drive shaft 309.

The linkage portion 109 may include an outer shell 325 enclosing aninterior housing 327 that may contain the support frame 313, rotarybearings 313, rotary drive shafts 309, 311 and drive systems 317, 319.FIG. 6 illustrates the linkage portion 109 with the outer shell 325partially removed. The outer shell 325 may define the first and secondmajor surfaces 301, 303 and sidewalls 305, 307, 308 and 310 of thelinkage portion 109. As shown, for example, in FIG. 2, the third andfourth sidewalls 308 and 310 of the linkage portion 109 may have arounded contour to enable the linkage portion 109 to pivot with respectto the ground and the patient support 103 with minimal clearance. Inembodiments, the outer shell 325 may be made from a plastic or carbonfiber material.

FIG. 6 illustrates the drive systems 317, 319 for driving the rotationof the rotary drive shafts 309, 311 relative to the linkage portion 109.In embodiments, the drive systems 317, 319 may have a mirroredconfiguration where two drive systems are rotated 180° within theinterior housing 327 of the linkage portion 109. For example, a firstdrive system 317 for driving the rotation of the first rotary driveshaft 309 may include a first motor 329 between the support plates 315that may be geared in to a first drive chain 331 that meshes with afirst sprocket wheel 333 coupled to the first rotary drive shaft 309.Thus, the first motor 329 may drive the rotation of the first rotarydrive shaft 309 and the pivoting of the patient support 103 with respectto the linkage portion 109. A second drive system 319 coupled to thesecond rotary drive shaft 311 may include a second motor between thesupport plates 315 (not visible in FIG. 6) that may be geared in to asecond drive chain 335 that meshes with a second sprocket wheel 337coupled to the second rotary drive shaft 311. The second sprocket wheel337 and the second rotary drive shaft 311 may be fixed to the baseportion 101 of the table system 100 (e.g., between bracket members 201).The second motor may drive the second drive chain 335 around the secondsprocket wheel 337, causing the linkage portion 109 to rotate on therotary bearing(s) and pivot with respect to the base portion 101. Rotaryencoders may be provided on one or more of the motor, gears or rotarybearings of each of the drive systems 317, 319 for indicating therelative rotational positions of the base portion 101, linkage portion109 and patient support 103.

As shown in FIG. 1, in some embodiments, the entire table system 100 maybe rotated and/or translated along at least one direction. For example,the base portion 101 of the system 100 may be mounted to a platform 400on a rotating bearing to enable the table system 100 to be rotated inthe direction of arrow 401. The rotating platform 400 may be mounted toa rail system 402 to enable the table system 100 to translate in atleast one direction, such as along the direction of arrows 403 and/orarrows 405. The rotation and translation motion of the table system 100may enable a patient to be loaded onto the patient support 103 when thetable system 100 in a first position and orientation and then moved to asecond position and/or orientation to perform an imaging scan. Forexample, the table system 100 may be rotated such that the patientsupport 103 is oriented in line with a patient imaging axis of animaging device (such as an x-ray CT scanner). Where the imaging devicehas a fixed bore, the entire table system 100 with the patient supportedthereon may be translated into the bore. It is noted that the relativerotational positions of the base portion 101, linkage portion 109 andpatient support 103 may remain fixed during the scan such that thetorque forces experienced along the length of the patient support 103remains constant, even when the table system 100 translates into theimaging bore. Thus, there may be no dynamic sagging of the patientsupport 103 during an imaging scan.

It will be understood that in some embodiments, the table system 100 maybe fixed to a floor or other support surface 102 and may not rotateand/or translate as illustrated in FIG. 1.

A control system 500 (e.g., a processor and memory) may be operativelycoupled to the table system 100, as schematically illustrated in FIG. 6.The control system 500 may be located partially or completely within thetable system 100 (e.g., within the linkage portion 109) and/or withinone or more separate components, such as a workstation, an imagingsystem or a mobile cart. The control system 500 may receive positionfeedback data (e.g., rotary encoder data) from the table system 100 andmay send control signals to the motor(s) of the table system 100 tocause the motors to drive one or both of the rotary drive shafts 309,311 and pivot the linkage portion 109 and/or the patient support 103into a desired configuration. The linkage portion 109 and/or the patientsupport 103 may be pivoted to one or more pre-set configurations of thetable system 100 (e.g., stored in the memory of the control system 500)and/or the configuration may be controllably adjusted by a user using asuitable user input device 501 (e.g., buttons, joystick, computerkeyboard and/or mouse, touchscreen display, etc.).

Various pivot motions and operating modes of a table system 100according to an embodiment are now described with reference to FIGS.1-5. In embodiments, the table system 100 may be used to support apatient while performing a variety of imaging scans of the patient usingan imaging system. The imaging system may be an x-ray computedtomography (CT) imaging system. Examples of x-ray CT imaging devicesthat may be used according to various embodiments are described in, forexample, U.S. Pat. No. 8,118,488, U.S. Patent Application PublicationNo. 2014/0139215, U.S. Patent Application Publication No. 2014/0003572,U.S. Patent Application Publication No. 2014/0265182, U.S. PatentApplication Publication No. 2014/0275953, U.S. Provisional PatentApplication No. 62/425,746 and U.S. application Ser. No. 15/130,258, theentire contents of all of which are incorporated herein by reference. Itwill be understood that these embodiments are provided as illustrative,non-limiting examples of imaging systems suitable for use with a tablesystem 100 according to various embodiments, and that an embodimenttable system 100 may utilize various types of medical imaging devices.For example, alternatively or in addition to an x-ray CT device, a tablesystem 100 of the various embodiments may be used with an x-rayfluoroscopic imaging device, a magnetic resonance (MR) imaging device, apositron emission tomography (PET) imaging device, a single-photonemission computed tomography (SPECT), an ultrasound imaging device, etc.

In one non-limiting embodiment, the table system 100 may be used toobtain diagnostic images of a patient in a standing or weight-bearingposition. A patient may stand on the platform 105 of the patient support103, optionally with their body leaning or resting against the bed 107.A gantry of an imaging system may be moved such that the patient andpatient support 103 are positioned within the bore of the gantry, suchas by lowering the gantry over the patient and patient support 103 (oralternatively, raising the patient and patient support 103 into the boreof the gantry). An example of a system for performing an x-ray CTimaging scan of a patient in a weight-bearing position is described inU.S. Patent Application Publication No. 2014/0139215, which waspreviously incorporated by reference.

In some embodiments, the table system 100 may be used to move a patientbetween a lying position (i.e., where the patient support 103 extends ina generally horizontal direction with the patient supported primarily bybed 107) and a standing or weight-bearing position (i.e., where thepatient support 103 extends in a generally vertical direction with thepatient supported primarily by platform 105). In embodiments, a patientmay be first loaded onto the patient support 103 in a lying position.The feet of the patient may be adjacent to the platform 105. An optionalrestraint (e.g., one or more Velcro® straps) may be utilized to securethe patient to the patient support 103. The patient support 103 alongwith the patient may then be tilted up into a standing or weight-bearingposition. Alternately, the patient may be loaded onto the patientsupport 103 in a standing position (e.g., the patient may step up ontothe platform 105) and the patient support 103 along with the patient maybe tilted down into a lying position.

FIG. 1 illustrates the table system 100 in a first configuration. Inthis configuration, the linkage portion 109 lies flat and parallel tothe support surface 102 (e.g., the floor). The bracket members 201 ofthe base portion 101 and the bracket members 119 of the patient support103 are adjacent to the first and second side walls 305, 307 (see FIGS.2-3) of the linkage portion 109. The second portion 113 of the patientsupport 103 may extend over and parallel to the first major surface 301of the linkage portion 109. The first portion 111 of the patient support103 may extend vertically upward from and perpendicular to the firstmajor surface 301 of the linkage portion 109. The configuration of FIG.1 may provide a relatively small footprint with the base portion 101,linkage portion 109 and patient support 103 folded over one another in acompact manner.

FIG. 2 illustrates the pivoting motion of the patient support 103 withrespect to the linkage portion 109 in the direction of arrow 600. InFIG. 2, the patient support 103 is tilted about 45° with respect to thelinkage portion 109. In embodiments, the patient support 103 may pivotwith respect to the linkage portion 109 over a range of at least about90°, and preferably at least 180° such as up to about 270°.

FIG. 3 illustrates the pivoting motion of the linkage portion 109 withrespect to the base portion 101 in the direction of arrow 601. As shownin FIG. 3, the linkage portion 109 is pivoted about axis α′ by 90° suchthat the first and second major surfaces 301, 303 of the linkage portion109 extend in a vertical direction and are oriented perpendicular to thesupport surface 102 (e.g., floor). In the configuration of FIG. 3, thepatient support 103 is pivoted 180° relative to the configuration ofFIG. 1, such that the second portion 113 of the patient support 103 isnow offset from and parallel to the second major surface 303 of thelinkage portion 109. The first portion 111 of the patient support 103extends in a horizontal direction perpendicular to the second majorsurface 303 of the linkage portion 109.

FIG. 4 shows another configuration in which the linkage portion 109 hasbeen pivoted 180° from the configuration of FIG. 1 such that the firstmajor surface 301 of the linkage portion 109 now lies horizontal againstthe support surface 102 (e.g., the floor) and the second major surface303 of the linkage portion 109 faces vertically upwards. In thisconfiguration, the patient support 103 has been pivoted 270° relative tothe configuration of FIG. 1, such that the second portion 113 of thepatient support 103 extends vertically upward from and perpendicular tothe second major surface 303 of the linkage portion 109, and the firstportion 111 of the patient support 103 extends in a horizontal directionover and parallel to the second major surface 303 of the linkage portion109.

An advantage of the configuration of FIG. 4 is that it may facilitateeasy loading and unloading of a patient to and from the patient support103. In many cases, it can be challenging for a patient to get onto orbe placed onto a conventional table for an imaging device. Often,particularly in the case of sick or infirm patients, this may requirelifting patient from a gurney up onto a dedicated radiology table, whichcan be problematic for the medical staff. A table system 100 accordingto various embodiments may be lowered such as shown in FIG. 4 so thatthe bed 107 on which the patient is supported may be at a comfortableheight for loading and unloading of the patient. For example, the bed107 may be at a height of no more than about 50 cm, such as between 30and 40 cm from the floor. This may allow a patient to easily climb ontoor be lowered down onto the bed 107, which may be easier for both thepatient and the medical staff members.

The patient support 103 may then be raised from the lowered position ofFIG. 4 to a height suitable for an imaging scan (e.g., such that thepatient support 103 may be positioned within the bore of an imagingdevice). In embodiments, the patient support 103 may be raised to raisethe bed 107 to a height of one meter or more from the floor. FIG. 3shows the patient support 103 raised to a maximum height for performinga scan of a patient supported in a horizontal lying position on the bed107. The patient support 103 may be raised to any height between thelowered position in FIG. 4 and the raised position of FIG. 3 bycontrolling the relative pivoting motions of the base portion 101,linkage portion 109 and patient support 103. A control system 500 of thetable system 100 (see FIG. 6) may coordinate the pivoting motions sothat bed 107 stays generally horizontal as the patient support 103 israised and lowered. The bed 107 may also be moved to an inclinedposition at any arbitrary angle (e.g., ±30° from the horizontal positionshown in FIGS. 3 and 4). In embodiments, this may enable the patient tobe supported in Trendelenburg and/or reverse Trendelenburg positions.

FIG. 5 illustrates the table system 100 in a configuration suitable forimaging a patient in a standing or weight-bearing position. Inembodiments, the patient support 103 may be pivoted upwards by apre-determined angle (e.g., 90°) from the lowered position shown in FIG.4 to the position shown in FIG. 5. In the configuration of FIG. 5, thepatient support 103 is supported in a cantilevered manner from thelinkage portion 109 by the bracket members 119. The patient may besupported in a standing position on the platform 105, which is parallelto the support surface 102 (e.g., floor). The patient support 103 may bepivoted to any arbitrary angle with respect to the linkage portion 109,such as an angle between 0-90° from the surface 303 of the linkageportion 109 so that the weight of the patient may be partially supportedby the platform 105 and partially supported by the bed 107. An imaginggantry of an imaging device (e.g., x-ray CT scanner) may scan the entirelength of the patient without interference from either the linkageportion 109 or the base portion 101 of the table system 100.

Various examples of diagnostic imaging applications that may beperformed on a human or animal patient in a weight-bearing positionusing the present table system 100 include, without limitation:

Imaging the bones of a foot. The three-dimensional relationships of thebones in the foot in a flatfoot deformity are difficult to assess withstandard radiographs. CT scans demonstrate these relationships but aretypically made in a non-weightbearing mode. The use of a weightbearingCT or other imaging apparatus may be useful in imaging the feet inpatients with severe flexible pesplanus deformities and to better definethe anatomical changes that occur.

Imaging of a limb (e.g. leg). Weight-bearing (CT) bilateral long leg hipto ankle examination and non-weight bearing cross-sectional imaging (CT)of the affected limb may be performed on the hip, knee and ankle, forexample, and may be useful for determining variations in angulation andalignment accuracy for diagnosis and/or surgical planning.

Imaging of a spine. Weight bearing scanning (e.g., CT scanning) may beuseful for improvements in the accurate diagnosis of degenerative spinaldisorders by scanning a patient in the “real life” standing position. Byscanning in the standing position, the spinal disc and facet jointcompresses, which may enable more specific and precise diagnosis ofdegenerative spine disorders.

Imaging of a joint (e.g., knee). Weight bearing scanning (e.g., CTscanning) of the knee may enable more specific and precise diagnosis ofthe patella-femoral kinematics and may also be useful in surgicalplanning.

Angiography. Weight bearing angiography (e.g., CT angiography) mayenable more accurate diagnosis, and may be used, for example, to examinethe pulmonary arteries in the lungs to rule out pulmonary embolism, aserious but treatable condition. Weight bearing angiography may also beused to visualize blood flow in the renal arteries (those supplying thekidneys) in patients with high blood pressure and those suspected ofhaving kidney disorders. Narrowing (stenosis) of a renal artery is acause of high blood pressure (hypertension) in some patients and can becorrected. A special computerized method of viewing the images makesrenal CT angiography a very accurate examination. This is also done inprospective kidney donors. Weight bearing angiography may also be usedto identify aneurysms in the aorta or in other major blood vessels.Aneurysms are diseased areas of a weakened blood vessel wall that bulgesout—like a bulge in a tire. Aneurysms are life-threatening because theycan rupture. Weight bearing angiography may also be used to identifydissection in the aorta or its major branches. Dissection means that thelayers of the artery wall peel away from each other—like the layers ofan onion. Dissection can cause pain and can be life-threatening. Weightbearing angiography may also be used to identify a small aneurysm orarteriovenous malformation inside the brain that can belife-threatening. Weight bearing angiography may also be used to detectatherosclerotic disease that has narrowed the arteries to the legs.

A table system 100 such as shown and described may also be used tosupport a patient for interventional radiology procedures and externalbeam radiation (e.g., LINAC) treatment procedures.

The foregoing method descriptions are provided merely as illustrativeexamples and are not intended to require or imply that the steps of thevarious embodiments must be performed in the order presented. As will beappreciated by one of skill in the art the order of steps in theforegoing embodiments may be performed in any order. Words such as“thereafter,” “then,” “next,” etc. are not necessarily intended to limitthe order of the steps; these words may be used to guide the readerthrough the description of the methods. Further, any reference to claimelements in the singular, for example, using the articles “a,” “an” or“the” is not to be construed as limiting the element to the singular.

The preceding description of the disclosed aspects is provided to enableany person skilled in the art to make or use the present invention.Various modifications to these aspects will be readily apparent to thoseskilled in the art, and the generic principles defined herein may beapplied to other aspects without departing from the scope of theinvention. Thus, the present invention is not intended to be limited tothe aspects shown herein but is to be accorded the widest scopeconsistent with the principles and novel features disclosed herein.

What is claimed is:
 1. A table system for use with an imaging device,comprising: a base portion that supports the table system over a supportsurface; a patient support comprising a platform sized and shaped tosupport a patient in a standing position and a bed sized and shaped tosupport the patient in a lying position; a linkage portion coupledbetween the base portion and the patient support that is pivotable withrespect to both the base portion and the patient support; a first drivemechanism that drives the pivoting of the patient support with respectto the linkage portion; and a second drive mechanism that drives thepivoting of the linkage portion with respect to the base portion, thefirst and second drive mechanisms moving the patient support between avertical position in which the platform is substantially parallel to thesupport surface and a horizontal position in which the bed issubstantially parallel to the support surface; wherein the patientsupport is coupled to the linkage portion by a first rotary shaftconfigured to enable the patient support to pivot with respect to thelinkage portion, and the base portion is coupled with the linkageportion by a second rotary shaft configured to enable the linkageportion to pivot with respect to the base portion; and wherein the firstdrive mechanism comprises a first motor geared into a first drive chainthat meshes with a first sprocket wheel coupled to the first rotaryshaft and the second drive mechanism comprises a second motor gearedinto a second drive chain that meshes with a second sprocket wheelcoupled to the second rotary shaft.
 2. The table system of claim 1,wherein the first drive mechanism and the second drive mechanism arelocated in the linkage portion.
 3. The table system of claim 1, whereinthe patients support is movable to any arbitrary angle between thevertical position and the horizontal position.
 4. The table system ofclaim 1, wherein the linkage portion pivots with respect to the baseportion and the patient support to lower the patient support to a firstheight above the support surface and raise the patient support to asecond height above the support surface.
 5. The table system of claim 4,wherein the bed is no more than about 50 cm above the support surfacewhen the patient support is at the first height.
 6. The table system ofclaim 4, wherein the bed is at least one meter above the support surfacewhen the patient support is at the first height.
 7. The table system ofclaim 4, wherein the patient support may be moved to any arbitraryheight between the first height and the second height while maintainingthe patient support in a horizontal position.
 8. The table system ofclaim 4, wherein the first drive mechanism drives the pivoting of thepatient support with respect to the linkage portion to move the patientsupport from a horizontal position at the first height to a verticalposition for performing a weight-bearing imaging scan.
 9. The tablesystem of claim 1, wherein the patient support is composed of at leastone radiolucent material over a first portion of the patient supportthat includes at least the platform and the bed.
 10. The table system ofclaim 9, wherein the at least one radiolucent material comprises carbonfiber.
 11. The table system of claim 9, wherein the patient supportcomprises at least one reinforcing element composed of a non-radiolucentmaterial, wherein the at least one reinforcing element is located in asecond portion of the patient support to enable a patient supported onat least one of the platform and the bed to be imaged using an x-raycomputed tomography (CT) imaging device over a full length of thepatient without imaging the at least one reinforcing element.
 12. Thetable system of claim 1, wherein the patient support comprises a concavesurface defining the bed.
 13. The table system of claim 12, wherein thepatient support comprises rounded surfaces to minimize x-ray attenuationby the patient support.
 14. The table system of claim 2, wherein thepatient support comprises a first pair of bracket members extending atleast partially over first and second sidewalls of the linkage portionand coupled to the linkage portion via the first rotary shaft to enablethe patient support to pivot with respect to the linkage portion, andthe base portion comprises a second pair of bracket members mounted tothe support surface and extending at least partially over the first andsecond sidewalls of the linkage portion, the second pair of bracketmembers coupled to the linkage portion via the second rotary shaft toenable the linkage portion to pivot with respect to the base portion.15. The table system of claim 14, wherein the first and second pairs ofbracket members have complementary angled surfaces.
 16. The table systemof claim 14, wherein the linkage portion comprises a support frame thatsupports rotary bearings enabling the first and second rotary shafts torotate relative to the linkage portion.
 17. The table system of claim14, wherein the first and second drive mechanisms have a mirroredconfiguration that is rotated by 180° within an interior housing of thelinkage portion.
 18. The table system of claim 14, wherein the linkageportion comprises first and second major surfaces opposite to oneanother with the first and second sidewalls extending between the firstand second major surfaces, and the linkage portion is pivotable at least180° with respect to the base portion from a first position in which thefirst major surface of the linkage portion is oriented parallel to andfacing away from the support surface and a second position in which thefirst major surface of the linkage portion is oriented parallel to andfacing towards the support surface.
 19. The table system of claim 18,wherein the patient support is pivotable at least 270° with respect tothe linkage portion from a first position in which the platform islocated at least partially over and parallel to the first major surfaceof the linkage portion and a second position in which the platform islocated at least partially over and perpendicular to the second majorsurface of the linkage portion.
 20. The table system of claim 18,wherein the linkage portion comprises third and fourth sidewallsextending between the first and second surfaces on opposite sides of thelinkage portion, the third and fourth sidewalls having a rounded contourto enable the linkage portion to pivot with respect to the supportsurface and the patient support with minimal clearance.
 21. The tablesystem of claim 1, wherein the base portion is coupled to at least oneof a rotary bearing that enables the table system to be rotated on thesupport surface and a rail system that enables the table system to betranslated along at least one direction on the support surface.